• Mary Lou Sole, Steven Talbert, Xin Yan, Daleen Penoyer, Devendra Mehta, Melody Bennett, Kimberly Paige Emery, Aurea Middleton, Lara Deaton, Bassam Abomoelak, and Chirajyoti Deb.
• University of Central Florida College of Nursing, Orlando, Florida.
• J Adv Nurs. 2019 Nov 1; 75 (11): 3045-3057.

AimsTo evaluate a deep oropharyngeal suction intervention (NO-ASPIRATE) in intubated patients on microaspiration, ventilator-associated events and clinical outcomes.DesignProspective, two-group, single-blind, randomized clinical trial.MethodsThe study was conducted between 2014 - 2017 in 513 participants enroled within 24 hr of intubation and randomized into NO-ASPIRATE or usual care groups. Standard oral care was provided to all participants every 4 hr and deep oropharyngeal suctioning was added to the NO-ASPIRATE group. Oral and tracheal specimens were obtained to quantify α-amylase as an aspiration biomarker.ResultsData were analysed for 410 study completers enrolled at least 36 hr: NO-ASPIRATE (N = 206) and usual care (N = 204). Percent of tracheal specimens positive for α-amylase, mean tracheal α-amylase levels over time and ventilator-associated events were not different between groups. The NO-ASPIRATE group had a shorter hospital length of stay and a subgroup with moderate aspiration at baseline had significantly lower α-amylase levels across time.ConclusionHospital length of stay was shorter in the NO-ASPIRATE group and a subgroup of intervention participants had lower α-amylase across time. Delivery of standardized oral care to all participants may have been an intervention itself and possibly associated with the lack of significant findings for most outcomes.ImpactThis trial compared usual care to oral care with a deep suctioning intervention on microaspiration and ventilator-associated events, as this has not been systematically studied. Further research on the usefulness of α-amylase as an aspiration biomarker and the role of oral suctioning, especially for certain populations, is indicated.Trial Registration NumberClinicalTrials.gov: NCT02284178.© 2019 John Wiley & Sons Ltd.

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